Whelehan P, Vinnicombe S J, Brown D C, McLean D, Evans A
Medical Research Institute, University of Dundee, Ninewells Hospital & Medical School, Dundee DD1 9SY, UK.
Medical Research Institute, University of Dundee, Ninewells Hospital & Medical School, Dundee DD1 9SY, UK.
Clin Radiol. 2014 Aug;69(8):849-52. doi: 10.1016/j.crad.2014.03.021. Epub 2014 Jun 2.
To assess how accurately the sentinel lymph node (SLN) can be identified percutaneously, using gamma probe and ultrasound technology.
Women with breast cancer, scheduled for wide local excision or mastectomy with SLN biopsy (SLNB), were included. Peri-areolar intradermal injection of technetium-99 nanocolloid was performed on the morning of surgery and 1-2 ml of blue dye was injected in the peri-areolar region once the patient was anaesthetized. Prior to surgery, a gamma probe was used over the skin to identify any hot spot that could represent a SLN. Ultrasound, guided by the hot spot, was then used to visualize potential SLNs and guide the insertion of a localizing wire. The accuracy in localizing the SLN by preoperative gamma-probe guided ultrasonography was assessed by comparison to SLNB.
A SLN was correctly identified and marked using gamma-probe guided ultrasonography in 44 of 59 cases (75%; 95% CI: 63-86%).
This study supports the case for investigating percutaneous gamma probe and ultrasound guided interventions in the axilla in women with breast cancer, as a potential alternative to surgical SLNB.
评估使用γ探针和超声技术经皮识别前哨淋巴结（SLN）的准确性。
纳入计划行局部广泛切除或乳房切除术并行前哨淋巴结活检（SLNB）的乳腺癌女性患者。手术当天上午在乳晕周围皮内注射99锝纳米胶体，患者麻醉后在乳晕周围区域注射1 - 2毫升蓝色染料。手术前，使用γ探针在皮肤上寻找可能代表前哨淋巴结的热点。然后在热点引导下使用超声观察潜在的前哨淋巴结并引导定位线的插入。通过与前哨淋巴结活检结果对比，评估术前γ探针引导下超声检查在前哨淋巴结定位中的准确性。
59例患者中，44例（75%；95%可信区间：63 - 86%）通过γ探针引导下超声检查正确识别并标记了前哨淋巴结。
本研究支持对乳腺癌女性患者经皮γ探针和超声引导下腋窝干预进行研究，作为手术前哨淋巴结活检的一种潜在替代方法。
